The invention is directed to a closing means for longitudinally extending hollow organs comprising a flexible wall and a passage. The invention is further directed to a method for closing such hollow organs, or limiting the passage through. Such hollow organs may be organs in an animal body or a human body, for example.
Closing means for closing or constricting hollow organs are generally known. German Laid Open Publication DE-A-4109314, for example, describes an implantable device for closing a vessel, in particular a blood vessel, in the body of a living being. The device comprises a longitudinal flexible plate to be fastened around the vessel, wherein a plurality of communicating bubbles is provided on one side of the plate. After the plate has been fastened around the vessel, the bubbles are filled with a fluid so that they expand and press circularly against the walls of the vessel to close the same either partly or completely.
Moreover, means for constricting the stomach passage opening are known that take the form of so-called gastric bands. Gastric bands are used in treating pathologic overweight, the so-called morbid adiposity. Corresponding implants are also employed in so-called gastric restriction surgery.
Two types of such gastric restriction surgery have become widely accepted. The so-called “gastric banding” and the so-called “gastric bypass”.
In “gastric banding”, the entrance region of the stomach, the so-called stoma opening, is constricted by a gastric band in the form of an implanted plastic material band, e.g. of silicone, so that a stomach pouch is formed. The stomach pouch has only a small passage to the remaining part of the stomach, due to the constriction by the gastric band, so that a patient will feel saturated already after having consumed a small amount of food or that he can consume only a certain amount of food in a certain period of time. However, there is a risk that the constricted stomach pouch becomes bulged and expands. With all gastric bands, there is a further risk of the band becoming displaced or penetrating into the stomach wall.
Especially when using the above mentioned annular closing means having a circularly expandable part, so-called pressure necroses may occur because of the pressure acting on the wall of the organ.
With a “gastric bypass”, the upper part of the stomach is separated by means of retaining staple lines, so that the lower stomach part and the duodenum are completely deactivated. The upper stomach part is connected with a loop of the small intestine pulled up to that stomach part and serving as a bypass for the remaining stomach and the duodenum. This kind of surgery is deemed irreversible, which is critical in the event of future complications such as malabsorptions. Further, the separated stomach part and the duodenum can no longer be reached endoscopically for diagnosis or treatment.
In a development of the “gastric bypass”, a combination of this surgical method and the use of a gastric band has been tested. Here, a part of the stomach is pinched off entirely with a gastric band and a corresponding bypass connection of the upper stomach part with the small intestine is established. This method is not generally irreversible, but the known problems in connection with gastric bands, e.g. pressure necroses or erosion, still exist. The gastric band must also exert high pressure on the stomach wall in order to complete the closure of the stomach passage.
For the above described method, practice has shown that, for a complete closure of the stomach part, a gastric band has to exert so high a pressure on the stomach walls that necroses and a penetration into the stomach wall necessarily have to occur so that the method is not practicable. The gastric band in contact with the small bowel loop can perforate at that level too.
Therefore, it is an object of the present invention to provide a closing means of the kind mentioned at the beginning, wherein, while avoiding the above mentioned disadvantages, a passage of a hollow organ with a flexible wall, especially in an animal body or a human body, may be closed reversibly.